I've worked with several women who had injuries to one breast and couldn't
heal or tolerate the repeated mastitis (to which they were more vulnerable
given the inflammation from the injuries).  My approach (working in concert
with a breast surgeon in one case, and the OB in the other 2 cases) is to
suggest a unilateral weaning.  The doctors weren't sure that was possible
because they assumed that the hormones would equally affect both breasts.  I
explained to them the endocrine and autocrine control for bfg.  Long term
milk maintenance is, luckily, an autocrine (or milk removal dependant)
process.  Hormones don't play much role in lactopoesis.  Consequently, doing
a very gradual wean down is the way to proceed, sometimes with assistance
from maintenance doses of antibiotics until the worst of the engorgement
related issues subside.  In the cases I worked with, the injured breast
weaned, and the other remained productive, allowing the mother to continue
breastfeeding.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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